PSS9 ECONOMIC BURDEN AND HEALTHCARE RESOURCE UTILIZATION IN PATIENTS WITH PRURIGO NODULARIS IN THE UNITED STATES

Abstract

Prurigo nodularis (PN) is a chronic dermatosis characterized by severely pruritic nodules. In addition to PN’s significant impact on quality of life, many patients are recalcitrant to therapy with no FDA-approved therapies to date. Despite this, little is known about real-world healthcare resource utilization and economic burden in prurigo nodularis in the US setting. IBM’s MarketScan Commercial Claims database was analyzed between October 2015 and December 2016. ICD-10-CM codes were used to identify patients age 18-64 years with PN and 3 additional cohorts without PN: age and sex-matched controls, atopic dermatitis, and psoriasis. Relative cost ratios were calculated generalized linear models with log link and gamma distribution. Incidence rate ratios were calculated using negative binomial regression. During the study period, 7,095 patients with PN, 16,595 matched controls, 23,915 patients with AD, and 39,346 patients with psoriasis were identified. Mean total healthcare spending per PN patient was $8,334, mostly in the outpatient setting ($5,580), followed by inpatient ($1,896), emergency department ($464), and pharmacy/lab costs ($394). Patients with PN incurred higher overall costs compared to matched controls (cost ratio 1.52), especially in pharmacy/lab (ratio 2.70) and outpatient expenditures (ratio 1.67). Patients with PN were >30 times as likely to be seen by dermatology compared to controls and >5 times as likely compared to AD or psoriasis respectively. PN patients were also more likely to have seen psychiatry compared to all groups (OR 1.45-2.03). For all above results, p<0.001. Prurigo nodularis is a chronic dermatosis with significant economic burden, incurring significantly higher overall healthcare costs compared to age and sex-matched controls. Furthermore, patients with PN more often require specialist care by dermatology and psychiatry. Optimizing clinical management of these patients may help mitigate the economic burden of PN and its impact on quality of life.